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目的:探讨配偶淋巴细胞体外诱生免疫联合地屈孕酮治疗对不明原因反复自然流产(URSA)患者再次妊娠结局及对孕妇围产期并发症的发生和新生儿发育的影响。方法:随访分析254例URSA患者,其中A组84例接受配偶淋巴细胞体外诱生免疫治疗;B组86例接受地屈孕酮治疗;C组84例接受体外诱生免疫联合地屈孕酮治疗;比较3组患者接受治疗后的再次妊娠成功率,以及围产期孕产妇的情况和新生儿的发育。结果:3组患者再次妊娠成功率分别为89.3%、70.9%和92.8%。B组低于其他各组,且差异有统计学意义(P<0.05)。3组患者新生儿的分娩孕周无统计学差异(P>0.05);足月新生儿出生体质量及身长组间无统计学差异(P>0.05);各组与正常参照标准比较差异无统计学意义(P>0.05)。3组间围产期妊娠并发症及新生儿畸形的发生率与流行病学调查数据比较无统计学差异(P>0.05)。结论:与单用地屈孕酮治疗比较,配偶淋巴细胞体外诱生免疫,或诱生免疫联合地屈孕酮治疗显著增加URSA患者再次妊娠的成功率;3种方法治疗均不影响新生儿生长发育;与正常妊娠相比,3种治疗均不增加孕妇围产期妊娠并发症与新生儿畸形率。
Objective: To investigate the effects of spleen lymphocyte immunotherapy in vitro combined with dydrogesterone on pregnant women with unexplained recurrent spontaneous abortion (URSA) and on the incidence of perinatal complications and neonatal development in pregnant women. Methods: A total of 254 patients with URSA were followed up, of which 84 patients in group A received immunotherapy with spleen lymphocytes induced in vitro; 86 patients in group B received dydrogesterone treatment; 84 patients in group C received in vitro immunization combined with dydrogesterone ; The success rate of re-pregnancy after three groups of patients were compared, as well as the situation of perinatal maternal and neonatal development. Results: The success rate of the third pregnancy was 89.3%, 70.9% and 92.8% respectively. B group was lower than the other groups, and the difference was statistically significant (P <0.05). There was no significant difference in gestational age between three groups (P> 0.05). There was no significant difference in birth weight and body length among full-term newborns (P> 0.05). There was no statistic difference between each group and the normal reference standard Significance (P> 0.05). There was no significant difference between the three groups in the incidence of perinatal pregnancy complications and neonatal malformations compared with the epidemiological survey data (P> 0.05). CONCLUSIONS: Splenic lymphocyte immunization in vitro or induced by immunization combined with dydrogesterone treatment significantly increased the success rate of re-pregnancy in URSA patients compared with dorso-progesterone alone. All three treatments did not affect the neonatal growth and development Compared with the normal pregnancy, the three kinds of treatment did not increase the pregnant women complications of pregnancy and neonatal malformations.